EVINS TEMPORARIES TIME CARD

Payroll Email: EvinsPayroll@HRnetConnection.com

Payroll Fax #: 512‐483‐9191 Payroll Phone #: 512‐454‐9561

Payroll Mail: 2013 West Anderson Lane Austin, Texas 78757

Fax by 5:00 PM each Monday to Evins Temporaries Payroll Dept.

PLEASE CROSS OUT ANY DAYS NOT WORKED BY EMPLOYEE In the event the named Evins employee on this time card is employed by us or transferred to another staffing service prior to completing 750 hours temporary employment through Evins within a 12 month period, we agree to pay a release fee in accordance with the published placement fee schedule currently in effect at Evins Personnel Consultants, Inc.

Evins Temporaries is not responsible for claims made under its Fidelity Bond unless such claims are reported in writing to it by Customer within 3 days after occurrence. Customer WILL NOT entrust Evins employees with cash, negotiable instruments, unattended premises, keys, or authorize Evins employees to operate motorized vehicles, machinery, or equipment without prior written permission from Evins.

Customerwill defend, indemnify and hold Evins harmless from any and all fines, penalties, and assessments, including attorney’s fees incurred by Evins as a result of any alleged violations of an Federal, State, or local law, regulation or ordinance with respect to premises owned or controlled by customers and to which Evins employees are assigned. Customer agrees to provide Evins employees assigned to it with safety and health training specific to the work to be performed.

Customer Verification and Signature

Company Name

Department

As a duly authorized representative of the customer, the undersigned hereby certifies (1) the hours shown are correct: (2) the

work was performed in a satisfactory manner; and (3) payment is authorized for services provided by Evins Temporaries.

Client Signature Date:

Print Name Title

Date Start

Time

End Time Less Meal

Time

Reg. Hrs. OT Hrs. Supervisor

Initials

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Total Hours for week to the nearest ¼ hour

Employee Certification and Signature Employee ID# I certify that the hours shown above represent the total hours worked by me on this assignment during the week ending designated and were properly verified by the client or by an authorized representative. I agree to notify Evins by phone within 8 hours at the end of each job assignment. If I fail to give said notice, Evins may assume that I am neither ready, willing, able or available for work. Failure to notify Evins may affect my unemployment benefits. No accident or injury was sustained unless so noted on the reverse of this time card.

Signature: Date:

New Address: Yes ____ Social Security Number Week Ending Saturday

XXX – XX ‐

Name:

Address:

City State Zip

Assignment#

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